I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care. The case was appealed to the qualified independent contractor, who also believed that the care, in this case, did not meet the CMS and CPT definitions of critical care. Subsequently, the case was appealed to the administrative law judge. The encounter occurred in an ...

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We tend to like threes. Hendriasis, in Greek — one through three, is a figure of speech used for emphasis in which three words are used to express one idea. For example: Veni vidi, vici. Location, location, location. Or one of the anthems of my youth — sex drugs and rock n' roll. Monty Hall had three doors on "Let’s Make a Deal." Even Uncle Junior, the patriarch in the “Sopranos,” ...

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